Which signs of increased intracranial pressure should the nurse assess in a 1-month-old infant?

Bulging fontanels is a key indicator of increased intracranial pressure (ICP) in infants. The fontanels are soft spots on an infant's skull where the bones have not yet fused together. In a healthy infant, these areas can be slightly soft and may even pulsate with the heartbeat. However, when ICP increases, it can cause the fontanels to bulge outward due to the pressure inside the skull. This physical change is observable and serves as a crucial clinical sign for healthcare providers monitoring an infant for potential neurological issues.

Increased pulse, headache, and high-pitched cry may be associated with altered neurological status in infants but are not specific or as easily assessed as bulging fontanels. An increased heart rate might occur for various reasons not directly related to ICP, and it can be challenging to ascertain whether an infant is experiencing a headache since they cannot verbalize discomfort. A high-pitched cry may indicate distress or pain but is not a definitive sign of increased ICP. Thus, among the options provided, bulging fontanels stands out as the most direct and observable sign.